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Remote Behavioral Health Utilization Review Jobs

Umpqua Health

Utilization Review Nurse

$85K - $105K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Review Nurse Remote Ability to travel on-site to 3031 NE Stephens St., Roseburg OR ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...

Umpqua Health

Utilization Review Nurse

$85K - $105K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Oscar Health

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... Health Care Insurance Company. * Knowledge of medical terminology and procedures. * Verbal and ...

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Remote Behavioral Health Utilization Review information

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How much do remote behavioral health utilization review jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for remote behavioral health utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is a remote behavioral health utilization review?

A Remote Behavioral Health Utilization Review job involves evaluating behavioral health treatment plans and services to ensure they meet insurance guidelines, medical necessity, and regulatory requirements. Professionals in this role review clinical documentation, assess patient needs, and collaborate with healthcare providers to determine appropriate levels of care. They work remotely, often for insurance companies or healthcare organizations, to authorize or deny coverage based on established criteria. Strong clinical knowledge, attention to detail, and communication skills are essential for success in this role.

What are the typical daily responsibilities for someone working in remote behavioral health utilization review?

In a Remote Behavioral Health Utilization Review role, your daily tasks often include reviewing clinical documentation, assessing medical necessity for behavioral health services, and making authorization or denial recommendations according to established guidelines. You’ll frequently interact with providers, case managers, and insurance representatives to gather information and clarify care requests. Additionally, your day may involve documenting decisions, participating in case review meetings, and staying updated on evolving policies. Working remotely, you'll communicate primarily via secure electronic systems, phone, and video conferencing. This structure typically offers flexibility but also requires strong self-motivation and organization.

What are the key skills and qualifications needed to thrive in remote behavioral health utilization review, and why are they important?

To excel in Remote Behavioral Health Utilization Review, candidates generally need a clinical background such as a nursing or social work license, strong analytical skills, and experience with behavioral health diagnoses and treatment planning. Familiarity with utilization management software, electronic health records (EHRs), and insurance coding systems is often required, along with certifications like CCM (Certified Case Manager) or URAC accreditation being valued. Excellent communication, critical thinking, and organizational skills help professionals handle complex cases and collaborate effectively in a virtual team environment. These competencies ensure accurate review of mental health services, compliance with payer requirements, and optimal patient outcomes.

More about Remote Behavioral Health Utilization Review jobs

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Remote Behavioral Health Utilization Review jobs near you
Infographic showing various Remote Behavioral Health Utilization Review job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 76% Full Time, 16% Part Time, and 6% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Management Clinician Behavioral Health

Avery Healthcare Group Ltd.

Remote

$63K - $87K/yr

Other

Posted 15 days ago

Job description

UM Clinician – Behavioral Health (Aetna Student Health)

Make an impact on student mental health through clinical expertise and care coordination. Join the Aetna Student Health Behavioral Health team and play a key role in ensuring members receive appropriate, high-quality behavioral health services through effective utilization management.

What You'll Do

  • Provides high-level scope of role and leadership in the utilization management process for behavioral health services, ensuring effective and appropriate utilization of resources.
  • Conducts comprehensive assessments and evaluations of members' behavioral health needs, utilizing evidence-based criteria and clinical expertise to determine the most appropriate level of care and treatment options.
  • Supports the core purpose of the job by collaborating with providers, members, and multidisciplinary teams to develop individualized care plans that promote positive clinical outcomes and recovery.
  • Applies in-depth knowledge and clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program with assigned patients.
  • Reviews and analyzes clinical documentation, treatment plans, and progress notes to ensure compliance with medical necessity criteria and quality standards, providing recommendations for care coordination and resource optimization.
  • Stays updated on industry guidelines, evidence-based practices, and emerging trends in behavioral health, utilizing this knowledge to inform decision-making, enhance clinical practice, and improve the quality of provided care.
  • Collaborates with stakeholders, such as providers, care managers, and community organizations, to establish effective communication channels that promote care coordination efforts and facilitate the resolution of UM inquiries and concerns.
  • Provides coaching and guidance to support the professional development of the UM team, promoting adherence to clinical guidelines, accuracy in documentation, and effective utilization management practices.
  • Ensures a culture of continuous improvement and best practices by participating in quality improvement initiatives, contributing to the development of UM policies and procedures, and striving for excellence in behavioral health utilization management.

What You Bring - Required

  • Active, unrestricted, independent clinical licensure in good standing, such as:
    • LCSW (Licensed Clinical Social Worker)
    • LMFT (Licensed Marriage and Family Therapist)
    • LMSW (Licensed Masters Social Worker)
    • LPC (Licensed Professional Counselor)
    • RN (Registered Nurse)
  • 3–5 years of behavioral health clinical experience
  • Strong clinical assessment, problem-solving, and decision-making skills
  • Knowledge of medical terminology and utilization management principles
  • Ability to manage sensitive information with professionalism and discretion
  • Strong communication and collaboration skills
  • Must be willing to work in MST or PST

Preferred Qualifications

  • 3–5 years of Managed Care or Utilization Management experience
  • Experience reviewing behavioral health services and treatment plans
  • Familiarity with care coordination and interdisciplinary collaboration
  • Knowledge of digital literacy skills

Education

  • Bachelor's or Master's degree in a relevant field, or equivalent professional training and qualifications
    • Bachelors in Nursing, Master's in Social Work/Counseling/Psychology

Why Join Us?

  • Opportunity to support behavioral health outcomes for college and university students
  • Collaborative, mission-driven team environment
  • Meaningful work that influences quality, access, and appropriate utilization of behavioral health services
  • Professional growth within a leading healthcare organization

If you're passionate about behavioral health and want to use your clinical expertise to improve access to quality care, we'd love to hear from you. Apply today!

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